Dry drug particle delivery system and method for ventilator circuits

Abstract

A system for introducing a dose from a metered dose inhaler canister into the inspiratory stream (1B) of a ventilator system including an inspiratory tube (32), a Y connector (3), and an endotracheal tube (7) intubated in a patient, including a valved T connector (30) having a valved port (30A) and first (30B) and second (30C) ports coupled to conduct the inspiratory stream (1B) through the valved T connector, an MDI canister (14), and a nozzle adapter structure (31) having a first port (31A) for insertion into the valved port (31A) to open a valve thereof and a nozzle (31B) receiving a stem (14A) of the MDI canister (14) and ejecting a plume (17) of MDI medication particles upon activation of the MDI canister. A dry gas inlet (31D) receives dry gas which flows through the nozzle adapter structure (31) into the valved port (30A) and into the inspiratory stream (1B), and carries the plume from the nozzle adapter structure (31) through the valved port (30A) into the inspiratory stream (1B).

What is claimed is: 
     
       1. Apparatus for introducing a measured dose of minute, dry medication particles into an inspiratory stream of a ventilator system including an inspiratory tube, a Y connector, and an endotracheal tube intubated in a patient, the apparatus comprising: (a) a connector having an inlet port and first and second ports coupled to conduct the inspiratory stream through the connector;   (b) a medication dispensing device actuatable to eject a plume constituting a measured dose of minute, dry medication particles, the medication dispensing device including a mouthpiece, an internal nozzle structure for electing an expanding plume of medication particles toward the mouthpiece, a boot portion having an open end in fluid communication with the mouthpiece, and an MDI canister within the boot portion and having a stem inserted into an inlet of the nozzle structure; and   (c) a closed plume-containing structure receiving an expanding plume of minute dry medication particles from the mouthpiece, the plume-containing structure having a first port for insertion into the inlet port to direct the expanding plume to flow through the inlet port into the inspiratory stream, through the endotracheal tube, and into the lungs of the patient.   
     
     
       2. Apparatus for introducing a measured dose of minute, dry medication particles into an inspiratory stream of a ventilator system including an inspiratory tube, a Y connector, and an endotracheal tube intubated in a patient, the apparatus comprising: (a) a connector having an inlet port and first and second ports coupled to conduct the inspiratory stream through the connector;   (b) a medication dispensing device actuatable to eject an expanding plume constituting a measured dose of minute, dry medication particles; and   (c) a closed plume-containing structure receiving the expanding plume of minute dry medication particles from the medication dispensing device, the plume-containing structure having a first port for insertion into the inlet port and a dry gas inlet coupled to a dry gas source and directing dry gas through the plume-containing structure to carry the expanding plume through the inlet port into the inspiratory stream, through the endotracheal tube, and into the lungs of the patient, the dry gas reducing absorption of moisture in the inspiratory stream by the medication particles.   
     
     
       3. Apparatus for introducing a measured dose of minute, dry medication particles into an inspiratory stream of a ventilator system including an inspiratory tube, a Y connector, and an endotracheal tube intubated in a patient, the apparatus comprising: (a) a valved connector having a valved inlet port and first and second ports coupled to conduct the inspiratory stream through the valved connector;   (b) a medication dispensing device actuatable to eject an expanding plume constituting a measured dose of minute, dry medication particles; and   (c) a closed plume-containing structure for receiving the expanding plume of minute dry medication particles from the medication dispensing device, the plume-containing structure having a first port for insertion into the valved inlet port and a dry gas inlet coupled to a dry gas source and directing dry gas through the plume containing structure to carry the expanding plume through the valved inlet port into the inspiratory stream, through the endotracheal tube, and into the lungs of the patient, the dry gas reducing absorption of moisture in the inspiratory stream by the particles.   
     
     
       4. Apparatus for introducing a dose from a metered dose inhaler canister into the inspiratory stream of a ventilator system including an inspiratory tube, a Y connector, and an endotracheal tube intubated in a patient, the apparatus comprising: (a) a valved connector having a valved port and first and second ports coupled to conduct the inspiratory stream through the valved connector;   (b) an MDI canister; and   (c) a nozzle adapter structure having a first port for insertion into the valved port to open a valve thereof, an internal nozzle structure for receiving a stem of the MDI canister and ejecting an expanding plume of medication particles upon activation of the MDI canister, a second port for receiving the expanding plume, and a dry gas inlet coupled to a dry gas source and directing dry gas through the nozzle adapter structure into the valved port and into the inspiratory stream;   the dry gas carrying the expanding plume from the nozzle adapter structure through the valved port into the inspiratory stream, through the endotracheal tube into the lungs of the patient, the dry gas reducing absorption of moisture in the inspiratory stream by the particles.   
     
     
       5. Apparatus for introducing a dose from a metered dose inhaler (MDI) into the inspiratory stream of a ventilator system including an inspiratory tube, a Y connector, and an endotracheal tube intubated in a patient, the apparatus comprising: (a) a valved T connector having a valved port and first and second ports coupled to conduct the inspiratory stream through the valved T connector;   (b) a metered dose inhaler including a mouthpiece, an internal nozzle structure for ejecting a plume of medication particles toward the mouthpiece, a boot portion having an open end in fluid communication with the mouthpiece, and an MDI canister within the boot portion and having a stem inserted into an inlet of the nozzle structure;   (c) a coupler having a first port for insertion into the valved port to open a valve thereof and a second port for coupling to the mouthpiece; and   (d) an end cap disposed on the open end of the boot portion, the end cap including a dry gas inlet coupled to a dry gas source and guiding dry gas to flow through the boot portion, mouthpiece, and coupler into the valved port and into the inspiratory stream,   the end cap including a depressible portion for transmitting an actuation force to the MDI canister to cause it to inject propellant containing medication particles into the nozzle structure and thereby causing the nozzle to eject an expanding plume of medication particles from which the propellant evaporates,   the dry gas carrying the plume through the coupler into the valved port and into the inspiratory stream, through the endotracheal tube into the lungs of the patient, the dry gas reducing absorption of moisture from the inspiratory stream by the medication particles.   
     
     
       6. The apparatus of claim 5 wherein the valved T connector is located between the Y connector and the endotracheal tube. 
     
     
       7. The apparatus of claim 5 wherein the valved port includes a valve which automatically opens when the coupler is inserted and automatically closes when the coupler is withdrawn from the valved T port. 
     
     
       8. The apparatus of claim 5 wherein the coupler and the end cap are disposed of elastomeric material, the depressible member including a flexible membrane over the open end of the boot portion. 
     
     
       9. The apparatus of claim 5 wherein the flow rate of the inspiratory stream is in the range of 25 to 125 liters per minute, and the dry gas flow rate is in the range of 8 to 15 liters per minute. 
     
     
       10. The apparatus of claim 5 wherein the dry gas inlet is integral with the end cap. 
     
     
       11. A method for introducing a measured dose of minute, dry medication particles into an inspiratory stream of a ventilator system including an inspiratory tube, a Y connector, and an endotracheal tube intubated in a patient, the method comprising: (a) providing a valved connector having a valved inlet port, and first and second ports coupled to conduct the inspiratory stream through the valved connector;   (b) actuating a medication dispensing device to eject a plume constituting a measured dose of minute, dry medication particles into a closed plume-containing structure, the plume-containing structure having a first port and a dry gas inlet coupled to a dry gas source;   (c) inserting the first port into the valved inlet port; and   (d) causing dry gas to flow and carry the plume through the valved inlet port into the inspiratory stream, through the endotracheal tube, and into the lungs of the patient,   the dry gas reducing absorption of moisture in the inspiratory stream by the particles.   
     
     
       12. A method for introducing a dose from an MDI inhaler into the inspiratory stream of a ventilator system including an inspiratory tube, a Y connector, and an endotracheal tube intubated in a patient, the method comprising: (a) providing a T connector having an inlet port, and first and second ports coupled to conduct the inspiratory stream through the T connector;   (b) enclosing (1) a mouthpiece of the MDI inhaler including an internal nozzle structure for ejecting a plume of MDI medication particles, a boot portion having an open end in fluid communication with the mouthpiece, and an MDI canister within the boot portion and having a stem inserted into an inlet of the nozzle structure, and a second port for insertion into the inlet port, and (2) the open end of the boot portion; and   (c) depressing a depressible portion of material enclosing the open end of the boot portion to transmit an actuation force to the MDI canister to cause it to inject a metered dose of propellant containing medication particles into the nozzle and thereby causing the nozzle to eject an expanding plume of the medication particles from which the propellant evaporates,   the plume moving through the inlet port into the inspiratory stream, through the endotracheal tube into the lungs of the patient.   
     
     
       13. A method for introducing a dose from an MDI inhaler into the inspiratory stream of a ventilator system including an inspiratory tube, a Y connector, and an endotracheal tube intubated in a patient, the method comprising: (a) providing a valved T connector having a valved port, and first and second ports coupled to conduct the inspiratory stream through the valved T connector;   (b) placing a first port of a coupler on a mouthpiece of an MDI inhaler including an internal nozzle structure for ejecting a plume of MDI medication particles, a boot portion of the MDI inhaler having an open end in fluid communication with the mouthpiece, and an MDI canister within the boot portion and having a stem inserted into an inlet of the nozzle structure, the coupler having a second port for insertion into the valved port to open a valve thereof;   (c) placing an end cap on the open end of the boot portion, the end cap including a dry gas inlet for coupling to a dry gas source;   (d) causing dry gas to flow from the dry gas source through the dry gas inlet into and through the boot portion and the mouthpiece through the valved port and into the inspiratory stream; and   (e) depressing a depressible portion of the end cap to transmit an actuation force to the MDI canister to cause it to inject a metered dose of propellant containing MDI particles into the nozzle structure and thereby causing the nozzle to eject an expanding plume of MDI particles from which the propellant evaporates,   the dry gas carrying the plume through the open valved port into the inspiratory stream, through the endotracheal tube into the lungs of the patient, the dry gas reducing absorption of moisture from the inspiratory stream by the MDI particles.